Workplace violence against female healthcare workers: a systematic review and meta-analysis

Abstract

Background: Workplace violence (WPV) is highly prevalent in the health sector and remains a major occupational issue causing significant harm, ranging from bodily and psychological harm to death. Female healthcare workers (HCWs) are at high risk of WPV.

Objectives: Identify risk factors of WPV among different professional categories of female HCWs.

Data sources: PubMed, EMBASE and Web of Science, along with their references lists January 2010 and March 2022.

Eligibility criteria: English language observational studies focusing on WPV among HCWs evaluating the risk factors, impacts and consequences of WPV in female HCWs.

Method: Risk of bias was assessed for all studies by Joanna Briggs Institute critical appraisal checklists. We estimated the pooled prevalence of WPV and the associated 95% CI using a random-effects meta-analysis model. We then described the associated factors and effects of WPV.

Results: 28 reviewed studies (24 quantitative, 4 qualitative and 1 mixed-method) from 20 countries were selected. From the available results of 16 studies, the pooled prevalence of WPV was estimated at 45.0% (95% CI 32% to 58%). Types of violence included verbal abuse, verbal threats, physical assaults, sexual harassment, mobbing, bullying and discrimination. Perpetrators were patients, patients' relatives, colleagues and supervisors. Nurses were the most studied HCWs category. WPV was found to affect both mental and physical health. Age, marital status, lower occupational position, substance abuse, shorter work experience and low support at work were the main socio-demographic and organisational factors associated with higher risk of WPV.

Conclusion: WPV prevalence is high among female HCWs, warranting a multilevel intervention approach to address and mitigate its impact. This approach should include targeted policies and individual-level strategies to create a safer work environment and prevent adverse effects on both HCWs and the broader healthcare system. Further research is needed to better document WPV in categories of HCWs other than nurses.

Prospero registration number: CRD42022329574.

Keywords: Health & safety; MENTAL HEALTH; Meta-Analysis; PUBLIC HEALTH; Risk Factors; Systematic Review.

Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart for selection of articles to include in the systematic review. WPV, workplace violence.

Figure 2. Random effect model forest plot for WPV among female healthcare workers. WPV, workplace violence.

Figure 3. Publication bias funnel plot for workplace violence among female healthcare workers.